$100-billion on health care, nothing to show for it: study

[GAP]

$100-billion on health care, nothing to show for it: study
Article Link
Postmedia News  Mar 21, 2012

By Derek Abma

OTTAWA — The Canadian health-care system has proven to be a black hole for federal tax dollars over the past decade or so, says a new report.

Despite hikes in federal transfers to provinces for health care that were $97.6-billion beyond what was needed to account for inflation and population growth in the past 13 years, there has been little improvement in access to care for Canadians, says the Fraser Institute study released Wednesday.

As an example, the report noted the time it takes to get treatment from a specialist after a referral from a general physician. The median time was 19 weeks last year, up almost 60% from 1997.

“Canadians should have expected the health-care system to improve, and it’s troubling that there has not been an improvement in spite of this very large increase in health-care expenditures since 1997-98,” said Nadeem Esmail, a senior fellow at the Fraser Institute and co-author of the study.

He said the Canada Health Act is constraining provinces from improving the efficiency of their systems. Allowing people to pay for quicker access to care, and more private-sector involvement in health insurance and delivery, while still ensuring universal access for all, are among the measures Mr. Esmail recommends.

“The core problem here is that the Canadian health-care system is relying on an inefficient model for health-care policy, that is we have a preponderance of government in the health-care system,” Mr. Esmail said. “Government is delivering health care and government is regulating health care.”

The report found that since 1997 wait times have increased for getting an appointment with a specialist after a referral, getting treatment from a specialist after the initial consultation, getting a CT scan and getting an ultrasound. It also found fewer nurses in proportion to the population, as well less availability of lithotripters (machines that break up kidney stones so they can be more easily passed).

The study did find improvements in four of the 11 factors it compared between 2011 and 1997; there were more physicians, MRI machines and CT scanners per capita, as well as shorter wait times to get an MRI.

However, Mr. Esmail said it’s a sign of the system’s general inefficiency that wait times for a CT scan increased despite greater availability of the equipment. He also noted that the number of available MRI machines increased 353.8% in proportion to the population, but wait times to use them fell by just 4.2%.

He said he is not suggesting a move toward U.S.-style health care, but something closer to the models in Switzerland, France and Japan. Those countries allow more private-sector involvement in universally accessible health-care systems and have produced better results than Canada has.
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[Brad Sallows]

1. I pay taxes and provincial health care premiums to support others, but can't get so much as a family doctor for my own needs; I must rely on clinic services (one complaint per visit, mind you).

2. My one chronic need/disability - poor eyesight - isn't covered.  (I suppose I am "denied" in the government's ongoing War Against People With Weak Lenses.)

3. Forgive me if once again don't join in the Kumbaya counter-chorus about what a wonderful health care system Canada has.

 

[cupper]

1. I pay taxes and provincial health care premiums to support others, but can't get so much as a family doctor for my own needs; I must rely on clinic services (one complaint per visit, mind you).

2. My one chronic need/disability - poor eyesight - isn't covered.  (I suppose I am "denied" in the government's ongoing War Against People With Weak Lenses.)

3. Forgive me if once again don't join in the Kumbaya counter-chorus about what a wonderful health care system Canada has.

At least you don't have to fight with some faceless paper pusher at your insurance company to get a prescription filled that your doctor feels is the best option. Especially when said insurance company flunky sends you a letter outlining the various conditions for which they will consider coverage. And you shake your head because of all of the conditions listed, the only one you don't have is age over 60.

 

[Brad Sallows]

I won't know about that unless I can see a doctor to get a prescription - or other service - first.  Not everything in any given Canadian province is covered.  I have an extended plan through my employer (ie. I have private health insurance - in Canada, if you can imagine).

 

[lethalLemon]

I won't know about that unless I can see a doctor to get a prescription - or other service - first.  Not everything in any given Canadian province is covered.  I have an extended plan through my employer (ie. I have private health insurance - in Canada, if you can imagine).

BC is a terrible province for anything Healthcare related, regardless of the $64+/month premium (greater is you have spouse + children) and on top, paying for extended plan through your employer. All kinds of money being shelled out and the coverage is minimal, and like you had mentioned - impossible to sign onto a family practitioner because you don't meet certain criteria (especially in Surrey, which I will refrain from listing as it will put me into internet forum purgatory).

I've been having a problem with a blood vessel in my tongue that is swelling and quite possibly infected; went to a clinic and the doc told me to gargle salt water. 2 days later, I was in excruciating pain and went to the hospital. Turns out the blood vessel in my tongue was "rejecting itself from my body" (don't ask me how or why, I'm not a doctor), it was surgically removed and I was billed. BC MSP only covered the portion of the cost bringing it down from OH GOD HEART ATTACK to First Born Child expensive, sent all the papers into my Extended Coverage provider and they told me I don't qualify for a reimbursement because I walked into the hospital on my own two feet - not by ambulance. Can you say ridiculous!?

Never had this kind of bulls**t in Alberta.

Edit: Apparently my English needs to be gooder 

 

[vonGarvin]

I know how to fix this: throw more money at it!
[/sarcasm]

But, seriously, the government is probably the last agency we ought to have running our health care system.  They ought to regulate it, setting standards of care, monitoring performance, etc, but because of the Sacred Cow of Canadian Health Care (SCCHC), any suggestion to change the system hears the screams, from the Left, usually (but not always) about our SCCHC!

So, we're shackled.  I say "accept it, and move on". 


Then we can criticise the Americans for having such a shitty system [/sarcasm]

 

[medicineman]

I think the system would likely be more efficient if we got rid of half the mid level beaurocrats that have niched themselves into a non-operator job and actually hire more health care providers and practitioners...hey, don't we have a thread somewhere about something similar in the CF? 

MM

 

[Journeyman]

When you have a hammer, everything looks like a nail. The author of the report, Nadeem Esmail, is an economist -- one with a track-record of government dislike. Therefore, the problem with our healthcare system is obviously too much government.

He appears to focus solely upon what he presumes healthcare should cost, based on 1999 figures plus inflation and population growth. Does he consider that people are whinier now, being more pre-disposed to hospital visits, so that his baseline hypothesis is invalid? Is there any possibility that more and more physicians are predisposed to insist on more people doing high-tech diagnostics, given the mind-boggling increase in malpractice lawyers? Is it remotely possible, given the "garbage in/garbage out" model, that the education system is pumping out less qualified doctors, who are obligated to be technicians in order to do their job?

I've no doubt that bureaucracy is a contributing factor, with each layer adding an exponential increase in 'public servants' drawing on the finances while contributing less and less (as mentioned by medicineman, who has to deal with them  ). I hardly think that it's the only finger that needs pointing though.

....unless one just has a particular economic axe to grind.

 

[Oldgateboatdriver]

When you have a hammer, everything looks like a nail.

..., given the mind-boggling increase in malpractice lawyers?

Carefull Journeyman You may be doing exactly what you see as bias in Mr. Esmail.

I am a lawyer (not a medical malpractice one) and have been on the board of the  Canadian Bar Association's national civil litigation section for many years (even president of the section). I can tell you that not only are there no increase in "malpractice" lawyers", mind-bogling or otherwise, but in fact, quite the reverse: In the last decade, for various reasons probably including the costs involved, the number of civil litigation cases has gone down in most provinces.

Sorry! Just could not let you pick on lawyers without godly retribution .

 

[Journeyman]

...the number of civil litigation cases has gone down in most provinces.

Probably because almost everyone gets the high-tech diagnostics, needed or not, to cover physicians' butts; it's too difficult to prove negligence -- "not my fault; the machine went beep."

Thus contributing to the hand-wringing increase in wait times.

 

[Oldgateboatdriver]

Interesting point of view.

But, would it not also be possible that the increase in high tech testing and diagnosis is a factor of their existence? I mean, those machines (for the most part) began to appear in the late 70's early 80's. As novelty, doctors knew precious little on their capability to help in diagnosis. Since then, the knowledge base relevant to diagnosis through those machines has basically doubled (if I understand my surgeon sister right) every five years, not to mention the explosion in the knowledge of the workings of the human body from recent research into DNA and cell biology with the attendant "new tests". Isn't it normal then, for doctors, to want to get the most precise diagnostic possible with the current testing methods, as opposed to sticking to old methods (reported symptoms, observed vital signs and "classic" tools such as basic X-ray only), without any forethought of malpractice?

Isn't it possible also that all these new tests and machines count for a great part of the explosion in the cost of medicine but that, as a corollary, we can treat many more illnesses and many illnesses better now than before?

Just asking, because Mr. Esmail does not seem to address this possibility.

 

[Journeyman]

Isn't it normal then, for doctors, to want to get the most precise diagnostic possible with the current testing methods....

Thus increasing wait times, but having nothing to do with "economics of evil government"

 

[mariomike]

I am a lawyer (not a medical malpractice one) and have been on the board of the  Canadian Bar Association's national civil litigation section for many years (even president of the section). I can tell you that not only are there no increase in "malpractice" lawyers", mind-bogling or otherwise, but in fact, quite the reverse: In the last decade, for various reasons probably including the costs involved, the number of civil litigation cases has gone down in most provinces.

That's good to hear. The City of Toronto pays for a $5 million medical malpractice insurance policy for each paramedic. It covers you on-duty, and off-duty.
Right now they are being sued for over ten million dollars for a single botched call.